Abstract
Objectives
Repair of complete atrioventricular septal defect (cAVSD) is routinely performed at
around 3 months of age with good results. However, some patients require earlier surgery
due to heart failure or failure to thrive. It is uncertain whether cAVSD repair performed
on patients ≤3.5 kg leads to increased mortality and reoperation on the left atrioventricular
valve.
Methods
All patients who underwent cAVSD repair from 1990 to 2019 at a single institution
were included in the study. Data were obtained from retrospective review of medical
records and correspondence with cardiologists.
Results
Of 456 patients, 12.9% (59/456) weighed ≤3.5 kg at time of repair. This group was
younger (P < .01) and had greater rates of heart failure (P < .01) and failure to thrive (P = .02). There was no significant difference in early mortality between the 2 groups
(1.7% [1/59] vs 3.0% [12/397], P = 1.0). Survival at 20 years was 83.8% in those ≤3.5 kg, compared with 90.4% in those
>3.5 kg, with no significant difference between the 2 groups (P = .68). Freedom from left atrioventricular valve reoperation at 20 years was 73.6%
in those ≤3.5 kg, compared with 74.5% in those >3.5 kg, with no significant difference
between the 2 groups (P = .45).
Conclusions
Repair of cAVSD in children ≤3.5 kg appears to be safe, with similar overall survival
and freedom from reoperation compared with those >3.5 kg. These findings add further
support to an approach of early complete repair in children with severe heart failure
or failure to thrive.
Graphical abstract
Graphical Abstract
Key Words
Abbreviations and Acronyms:
cAVSD (complete atrioventricular septal defect), CI (confidence interval), LAVV (left atrioventricular valve), LAVVR (left atrioventricular valve regurgitation), LVOTO (left ventricular outflow tract obstruction), PAB (pulmonary artery banding), VSD (ventricular septal defect)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 24, 2022
Accepted:
February 9,
2022
Received in revised form:
February 4,
2022
Received:
August 30,
2021
Footnotes
Dr Buratto is a recipient of a Postgraduate Scholarship from the National Health and Medical Research Council and an Australian Government Research Training Program Scholarship (1134340).
C. Goutallier and Dr Buratto contributed equally to this article.
Identification
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© 2022 by The American Association for Thoracic Surgery
